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| Effect of Midazolam combined with Early Mechanical Ventilation on the Cerebral Oxygenation Index Lung Function and Serum Inflammatory Factors in Children with Severe Hand-Foot-Mouth Disease |
| HU Dandan, HE Liya, LI Peiqing, et al |
| Guangzhou Women and Children's Medical Center, Guangdong Guangzhou 510623, China |
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Abstract Objective: To explore the effect of midazolam combined with early mechanical ventilation on the cerebral oxygenation index, lung function and serum inflammatory factors in children with severe hand-foot-mouth disease (HFMD). Methods: 60 children with severe HFMD who underwent mechanical ventilation in the pediatric intensive care unit of the hospital were randomly divided into the routine and the study group. All children were given nutritional support and anti-inflammatory treatment. On the basis, the study group was treated with intravenous injection of midazolam. The condition of hospitalization and prognosis was compared between the two groups. The cerebral oxygenation metabolism indexes, including cerebral oxygen consumption, cerebral oxygen extraction rate and amount of lactic acid produced in the two groups were calculated before and after treatment. The lung function and serum inflammatory factors were detected. The incidence of adverse reactions during treatment and the prognosis were statistically analyzed. Results: The length of ICU stay and duration of mechanical ventilation in the study group was shorter than that in the control group (P<0.05). After treatment, the cerebral oxygen consumption and amount of lactic acid produced in the study group [(57.3±9.3)%, (0.15±0.02) mmol/L] were significantly lower than those in the routine group [(67.7±12.6)%, (0.17±0.05) mmol/L], and the cerebral oxygen extraction rate [(62.3±11.2)%] was significantly higher than that in the routine group [(52.5±10.3)%] (P<0.05). The PEF, FVC and FEV1 in the study group [(86.4±7.5)%, (73.7±10.7) L, (83.7±12.3)%] were significantly higher than those in the routine group [(80.5±7.2)%, (65.7±9.8) L, (74.5±10.7)%] (P<0.05). Serum inflammatory cytokines IL-6, TNF-ɑ and PCT in the study group were significantly lower than those in the normal group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (10% vs 13.3%) (P>0.05). Conclusion: Midazolam combined with early mechanical ventilation can effectively improve the cardiopulmonary function and oxygenation index in children with severe HFMD, and promote their recovery.
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2018, Vol. 24 
